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Bridging the gap of referral to nephrology care

Optimal referral of patients who are at risk of kidney failure to nephrologists could improve their long-term outcomes. Various strategies, including the inclusion of kidney failure risk equations in electronic medical records and the active dissemination of clinical practice guidelines, could help to reduce the gap between optimal referral and what currently happens in clinical practice.

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References

  1. Tangri, N. et al. A predictive model for progression of chronic kidney disease to kidney failure. J. Am. Med. Assoc. 305, 1553–1559 (2011).

    Article  CAS  Google Scholar 

  2. Tangri, N. et al. Multinational assessment of accuracy of equations for predicting risk of kidney failure: a meta-analysis. J. Am. Med. Assoc. 315, 164–174 (2016).

    Article  CAS  Google Scholar 

  3. Wang, M., Peter, S. S., Chu, C. D., Tuot, D. S. & Chen, J. H. Analysis of specialty nephrology care among patients with chronic kidney disease and high risk of disease progression. JAMA Netw. Open 5, e2225797 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  4. Torreggiani, M. et al. Unmet needs for CKD care: from the general population to the CKD clinics-how many patients are we missing? Clin. Kidney J. 14, 2246–2254 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  5. Oliva-Damaso, N., Delanaye, P., Oliva-Damaso, E., Payan, J. & Glassock, R. J. Risk-based versus GFR threshold criteria for nephrology referral in chronic kidney disease. Clin. Kidney J. 15, 1996–2005 (2022).

    Article  PubMed  PubMed Central  Google Scholar 

  6. Yuen, J. et al. Risk of CKD progression and quality-of-care indicators in the primary care setting. Am. J. Kidney Dis. 81, 247–249 (2023).

    Article  PubMed  Google Scholar 

  7. Tangri, N. & Major, R. W. Risk-based triage for nephrology referrals: the time is now. Kidney Int. Rep. 6, 2028–2030 (2021).

    Article  PubMed  PubMed Central  Google Scholar 

  8. Shin, J.-I. et al. Albuminuria testing in hypertension and diabetes: an individual-participant data meta-analysis in a global consortium. Hypertension 78, 1042–1052 (2021).

    Article  CAS  PubMed  Google Scholar 

  9. Sparkes, D. et al. Patient perspectives on integrating risk prediction into kidney care: opinion piece. Can. J. Kidney Health Dis. 9, https://doi.org/10.1177/20543581221084522 (2022).

  10. Delanaye, P. et al. CKD: A call for an age-adapted definition. J. Am. Soc. Nephrol. 30, 1785–1805 (2019).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

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Correspondence to Nestor Oliva-Damaso.

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Oliva-Damaso, N., Tangri, N., Delanaye, P. et al. Bridging the gap of referral to nephrology care. Nat Rev Nephrol 19, 275–276 (2023). https://doi.org/10.1038/s41581-023-00693-1

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